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Integrative Women’s Health

Integrative Women’s Health by Victoria Maizes and Tieraona Low Dog (eds). New York, NY: Oxford University Press, Inc; 2010. Hardcover; 688 pages. ISBN 978-0-19-537881-8. $49.95.

Integrative Women’s Health resonates with warmth, care, and empathy, from the foreword by series editor Andrew Weil, MD, to the editors’ introductory chapter and epilogue, and throughout the contributing authors’ chapters. However, this is not a “touchy-feely” tome, but rather a clear, referenced presentation of the best evidence in the field, covering the most effective conventional treatments alongside relevant adjunct treatments and alternative or complementary approaches from varied traditional and contemporary practices. There is also an uncommon dose of common sense, recognizing that simple lifestyle changes, breathing exercises, or yoga practice may bring about profound health improvements, motivating patients to help and heal themselves.

The editors, Victoria Maizes, MD, and Tieraona Low Dog, MD, are recognized leaders in integrative medicine education and practice, and their selection of contributing authors and content achieves overall balance and impact. Chapters are grouped into sections: Lifestyle, Systems and Modalities, Reproductive Health, and Common Illnesses in Women. Across sections there is a unifying but flexible format whereby each chapter concludes with practical recommendations, resources, and references. So many edited collections seem fragmented; by contrast, this book forms a cohesive whole even though the chapters can be read separately and selectively.

Setting the tone, the editors’ chapter opens the Lifestyle section by expounding a general philosophy of integrative women’s health. Key is the building of a healing partnership whereby each practitioner explores the woman patient’s “beliefs, intuitions, and preferences for care,” providing an opportunity for the patient to tell her own story, maybe for the first time, and put her medical history into context. Many physicians may complain that this counsel of perfection is rarely possible when practicing under severe time constraints. The profound underlying message is nonetheless valid that “integrative medicine is not simply about learning to use new treatment options. It is about a different way of being with a patient.” Ultimately, spending time to get to know the patient may lead to a more effective treatment and a quicker path to long-term healing.

At times I felt uncomfortable with a near deification of women. “Women have the capacity to see the sacred in everyday life. In sunrises, in the changing colors of the mountain in the deserts, and in the laughter of a child, women may be reminded of the ineffable.” Is this not also true of men? While I agree that women are generally the glue that binds families together, the keepers of rituals, surely men also may be the holders and keepers of family, faith, and spirituality.

Through the topics of nutrition, dietary supplements, physical activity, mind-body therapies, and recognition of women’s “soul wounds,” the other chapters in the Lifestyle section continue the theme that patient empowerment, respect for their views, and “low tech” solutions may lead to powerful medicine. Additionally, practitioners may themselves benefit from refocusing practices between seeing patients.

Systems and Modalities covers ancient systems of medicine, represented here by Traditional Chinese Medicine (TCM) and Ayurveda. These traditional systems are characterized by an overarching cosmology and concepts of change and balance that provide new insights into women’s ailments. Disease is primarily explained in terms of patterns of disharmony; cure is a pathway for restoring balance and harmony. Similar dynamics are traced in energy medicine, homeopathy, and manual medicine, with discussions into how these modalities view and treat women’s health problems.

The section on Reproductive Health takes a different angle, focusing on the lifecycle of women from menstruation to menopause. Natural life events such as pregnancy and childbirth provide an excellent opportunity for the integrative practitioner to engage women in self-care practices and healthy choices that can endure a lifetime. While recognizing that conventional medicine has made childbirth safer, many women may choose to incorporate traditional birthing practices such as use of doulas or modern approaches like self-hypnosis for pain. Most practices can be integrated into the hospital environment. Similarly, menopause is a natural life stage that has become over-medicalized but could be seen as a time of “positive, life-changing insights, empowerment, and personal growth.”

Women’s lifecycle ailments, including chronic pelvic pain, endometriosis, and reproductive system cancers, are covered in separate chapters. In most cases, including in relatively mild problems such as vaginitis, an integrative approach will recognize the distress and often guilt that women may experience. Each chapter looks at conventional treatments and a range of alternative and complementary approaches from botanicals and supplements to lifestyle changes and mind-body practices. Integrative medicine so often denotes a laundry list of any treatment that has ever been linked with any particular health condition along with every associated caveat. This is not the case here. When discussing safety, prevention, and long-term health, the approach is rational, enabling, and positive—not clinically over-cautious and disempowering.

The final section, Common Illnesses in Women, departs from specific women’s issues to diseases that affect women differently from men: cardiovascular health, musculoskeletal problems, HIV, a range of mental conditions, and diseases of aging. The penultimate chapter looks at a whole woman approach to healthy aging, followed by the editors’ epilogue, which raises issues affecting the social construction of gender inequality in health: economic inequality, environmental factors, the paucity of clinical and scientific research on sex and gender differences, and the need to recognize women’s traditional role as healers.

Written by women, primarily for women, this book provides a powerful and practical set of guidelines for an integrative, celebratory, whole person approach to women’s health.

—Jacqueline C. Wootton President, Alternative Medicine Foundation, Inc. Director, HerbMed® HerbMedProTM Potomac, MD